国产化学发光法评估围孕期妇女TORCH感染情况及其IgM假阳性结果的分析  

An Analysis of Domestic Chemiluminescence Method for TORCH Infection inPeri-Pregnancy Women and False Positive Results of IgM

作　　者：郑维玲[1] 朱耿超[1] 石燕[1] 卢旬[1] 杨辰[1] 魏衍财[1] ZHENG Weiling;ZHU Gengchao;SHI Yan;LU Xun;YANG Chen;WEI Yancai(Department of Clinical Laboratory,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Municipal Hospital,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院医学检验科,江苏苏州215000

出　　处：《标记免疫分析与临床》2021年第7期1135-1140,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨苏州地区围孕期女性TORCH感染情况及流行特点,并对TORCH-IgM假阳性检测结果进行分析,为本地区围孕期女性保健提供参考依据。方法回顾性分析、统计2018年6月至2020年9月在南京医科大学附属苏州医院就诊的17984例围孕期女性TORCH检查结果,利用国产化学发光免疫分析法(CLIA)对TORCH的IgG以及IgM抗体进行检测,分析感染率。利用ELISA法对129例TORCH-IgM和IgG抗体双阳性血清进行IgG亲和力检测,分析IgM抗体假阳性结果。结果17984例TORCH检测结果中,IgG抗体阳性率由高到低依次为CMV(97.58%)、HSV-1(89.54%)、RV(78.81%)、HSV-2(10.88%)和TOX(2.83%)。IgM抗体阳性率由高到低依次为CMV(1.22%)、HSV-1(1.18%)、HSV-2(0.77%)、RV(0.57%)和TOX(0.36%),TOX感染阳性率最低,CMV感染阳性率最高。RV、CMV和HSV-1感染模式以IgM^(-)/IgG^(+)为主,TOX和HSV-2主要表现为IgM^(-)/IgG^(-)模式。按照季节统计,HSV-1-IgM在冬季阳性率最高(χ^(2)值8.36,P值0.04),TOX-IgM、RV-IgM、CMV-IgM和HSV-2-IgM各季节阳性率差异无统计学意义(χ^(2)值分别为2.51、4.16、1.84和5.12,P值分别为0.48、0.25、0.61和0.16)。TORCH-IgG抗体阳性率四季差异均无统计学意义。按照年龄分组统计,<35岁组CMV-IgG、HSV-1-IgG和HSV-2-IgG阳性率明显低于≥35岁组(χ^(2)值分别为12.34、15.04和238.36,均P<0.01),低年龄组TOX-IgG感染率明显高于高年龄组(χ^(2)值为10.01,P<0.01),两年龄组间RV-IgG和TORCH-IgM抗体阳性率差异无统计学意义。化学发光免疫分析法检测129例TORCH-IgM和IgG抗体双阳性标本中,仅19例(14.73%)检测结果为IgG低亲和力。结论苏州地区围孕期女性TORCH感染普遍,建议育龄女性孕前进行常规筛查,防止TORCH近期感染,预防出生缺陷。对于TORCH-IgM和IgG抗体双阳性结果可进一步联合IgG亲和力检测,排除TORCH感染假阳性。Objective To investigate the infection status and epidemic characteristics of TORCH among the periconceptional women in Suzhou area,and to analyze the false positive test results of TORCH IgM,so as to provide a reference for the health care of periconceptional women in this region.Methods A retrospective analysis was conducted to analyze results of TORCH examination of 17,984 periconceptional women who visited Suzhou Hospital affiliated to Nanjing Medical University from June,2018 to September,2020.Domestic Chemiluminescence immunoassay(CLIA)was applied to detect TORCH IgG and IgM antibodies to analyze the infection rate.ELISA method was conducted to detect the IgG affinity of 129 antibody double positive sera TORCH IgM and IgG,and we then analyzed the false positive results of IgM antibody.Results Results of 17984 TORCH tests showed that the positive rates of IgG antibodies in a descending order were:CMV(97.58%),HSV-1(89.54%),RV(78.81%),HSV-2(10.88%)and TOX(2.83%),respectively.Similarly,the positive rate of IgM antibodies in a descending order were:CMV(1.22%),HSV-1(1.18%),HSV-2(0.77%),RV(0.57%)and TOX(0.36%).Positive rate of TOXO was the lowest,while CMV was the highest.RV,CMV,and HSV-1 infection model were given priority to IgM^(-)/IgG^(+),while TOX and HSV-2 were mainly for IgM^(-)/IgG-^(-).According to seasonal statistics,HSV-1-IgM had the highest positive rate in winter(χ^(2)value was 8.36,P value was 0.04),and there is no difference in the positive rates of TOX-IgM,RV-IgM,CMV-IgM and HSV-2-IgM among seasons(χ^(2)value were 2.51,4.16,1.84,and 5.12,respectively,and the P values were 0.48,0.25,0.61,and 0.16,respectively).There was no significant difference in the positive rate of TORCH-IgG antibody among the four seasons.According to age grouping statistics,the positive rates of CMV-IgG,HSV-1-IgG and HSV-2-IgG in the<35-year-old group were significantly lower than those in the≥35-year-old group(χ^(2)values were 12.34,15.04 and 238.36,respectively,all P<0.01).The TOX-IgG infection rate in the<35-year-old g

关 键 词：TORCH感染 血清学检查 亲和力检测 

分 类 号：R714.7[医药卫生—妇产科学]